Perceptions of the Role of the Commercial Sector in Health

1. Perceptions of the Role of the Commercial Sector in Health Preliminary results from an informal survey of USG (USAID) stakeholders

2. Perceptions of the Role of the Commercial Sector in Health • Survey Objective • Better understand perceptions about benefits and risks associated with commercial sector role in health among funders (initially USAID) to inform PSP-One technical direction and develop Mainstreaming Strategy • Data • Semi-structured interviews with approximately 20 US and field-based HPN officers with geographic representation • Second phase • Will expand to include non-USG health donors (other bilaterals, multilaterals)

3. Preliminary Results • Principal contributions of private sector in health • Principal concerns regarding private sector in health • Perceptions of private sector’s role in health • Successful and not-so-successful approaches to working with the private sector in health

4. Principal Contributions Private/Commercial Sector in Health • Increasing availability/accessibility of services and products • Shifting those who can afford to pay off the public sector dole • Filling the gap when there are no public sector services or products • Accessing expertise beyond that typically available in public sector

5. Principal Concerns Regarding Role of Private/Commercial Sector in Health • Need to ensure quality and compliance with standard public health practice across broad range of private providers/distributors • Unease over compatibility of profit motive and servicing of public health objectives • Private sector is a drain on public sector staff where human capital is scarce

6. View of Private/Commercial Sector • USAID Washington staff observe support as being very strong and enduring (“part of Agency DNA”) • More variability among field missions – depending on Mission Director and HPN officer • Generational divide: old timers more public sector biased than most newcomers, notably FSLs, PSCs, fellows • Broad consensus that clients are principal beneficiaries of public private sector partnerships (PPPs) in health • Wide acknowledgement that private sector’s role in health is compatible with the achievement of public health objectives – although with underlying concerns.

7. Successful Approaches • Contracting Out • Franchises (for product distribution and service delivery) • Insurance schemes • Targeting and use of vouchers to encourage rational and equitable use of resources • Corporate Social Responsibility and “traditional” PPPs

8. Less Successful Approaches • Heavily subsidized (non-sustainable) social marketing programs • Mixed signals? • Short-term subsidies for social marketing, however, are seen as priming pump for expanded private sector presence in health

9. Observations General need for information on: • Engaging or motivating private sector in health • Effective approaches • Designing programs • Measuring impact Improve dissemination of information: • Make more accessible and engaging • Reach further out • Target key audiences (NEPs)

10. Next Steps • Complete interviews with non-USG donors [and with USG and non-USAID staff] • Synthesize and present results (PSWG, RCS presents) • Draft a PSP-One Mainstreaming Strategy • Convene panel on the private sector role in health to elaborate priority areas and determine specific approaches for addressing them • Develop and disseminate policy briefs • Private sector “myths and realities” • How to guides (e.g. contract out, assess legal and regulatory issues, procure and register generic drugs) • Coordinate high-level event in Africa with World Bank